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NABP North American Pharmacist Licensure Examination Sample Questions (Q131-Q136):

NEW QUESTION # 131
LN is 84 YOM who is in hospital for a back surgery. His height is 5 feet and 4 inches, weight 85 kg and NKDA.
His past medical history includes hypertension, diabetes mellitus, major depression, hypothyroidism and chronic back pain. Post-op day 1, LN's medication includes Dexamethasone 8mg iv q6h with taper dosing, Ondansetron 4mg iv q6h prn for N/V, Levothyroxine 0.075mg po daily, Lisinopril 10mg po daily, Citalopram
20mg po daily, Docusate sodium / Senna 1 tab po twice a day, Bisacodyl 10mg suppository daily prn for constipation, Famotidine 20mg iv q12hr, Metoclopramide 10mg iv q6h, Metformin 500mg po bid, D51/2NS with 20K at 125mls/hour and Hydromorphone PCA at 0.2mg/hour of basal rate, demand dose 0.1mg. lock-out every 6min, one hour limit 2.2mg/hour. Pertinent morning labs includes serum creatinine 1.4mg/dl, Mg 1.5mg/ dl, K 5.0mmol/L, Na 135mmol/L.
It is recommended to monitor complete blood count in patients on chronic metformin because of what reason?

A. Metformin may decrease platelet count
B. Metformin may decrease erythropoietin level
C. Metformin may decrease vitamin B12 levels
D. Metformin may cause leukocytosis
E. Metformin may decrease iron absorption

Answer: C

Explanation:
Explanation
Metformin may impair the absorption of vitamin B12, especially in those with inadequate vitamin b12 or calcium intake/absorption. Vitamin b12 deficiency can be treated with discontinuation of therapy or supplementation. Vitamin b12 serum concentrations should be monitored periodically with long-term therapy.

NEW QUESTION # 132
LN is 84 YOM who is in hospital for a back surgery. His height is 5 feet and 4 inches, weight 85 kg and NKDA.
His past medical history includes hypertension, diabetes mellitus, major depression, hypothyroidism and chronic back pain. Post-op day 1, LN's medication includes Dexamethasone 8mg iv q6h with taper dosing, Ondansetron 4mg iv q6h prn for N/V, Levothyroxine 0.075mg po daily, Lisinopril 10mg po daily, Citalopram
20mg po daily, Docusate sodium / Senna 1 tab po twice a day, Bisacodyl 10mg suppository daily prn for constipation, Famotidine 20mg iv q12hr, Metoclopramide 10mg iv q6h, Metformin 500mg po bid, D51/2NS with 20K at 125mls/hour and Hydromorphone PCA at 0.2mg/hour of basal rate, demand dose 0.1mg. lock-out every 6min, one hour limit 2.2mg/hour. Pertinent morning labs includes serum creatinine 1.4mg/dl, Mg 1.5mg/ dl, K 5.0mmol/L, Na 135mmol/L.
What is LN's creatinine clearance using Cockcroft and Gault equation based on IBW?

A. 43 mls/min
B. 23 mls/min
C. 53 mls/min
D. 33 mls/min
E. 63 mls/min

Answer: D

Explanation:
Explanation
ABW = 85 kg IBW = 50 kg + 2.3 kg (4) = 59.2 kg 85/59.2 = 1.44 AdjBW = 59.2 kg + 0.4(85 kg-59.2 kg) =
69.52
kg CrCl (IBW) = [(140-84) 59.2]/(72 * 1.4) = 32.8 CrCl (AdjBW) = [(140-84) 69.52]/(72 * 1.4) = 38.6

NEW QUESTION # 133
A 54-year-old male with a long history of mild persistent asthma on daily fluticasone therapy has been using his albuterol inhaler every day for the past month, and presents requesting a refill. What changes should be made to his current regimen?

A. Discontinue fluticasone and add ipratropium to current regimen
B. Add salmeterol to current regimen
C. Add ciclesonide to current regimen
D. Discontinue fluticasone and instead use salmeterol
E. Add cromolyn to current regimen

Answer: B

Explanation:
Explanation
Add salmeterol to the current regimen. This patient had mild persistent asthma but was using his albuterol daily, which indicates that a step up in therapy is warranted. The preferred first line treatment regimen for moderate persistent asthma are low to medium dose inhaled corticosteroids plus a long acting beta2 agonist, as well as a short acting beta2 agonist as needed. A is incorrect. Ciclesonide is an inhaled corticosteroid. The patient in the case is already using fluticasone, so adding ciclesonide would be therapeutic duplication. C is incorrect. Long-acting beta2 agonists should only be used as adjunctive therapy in patients who are currently receiving but not adequately controlled on an inhaled corticosteroid. These medications should not be used as monotherapy, due to an increased risk of asthma related deaths. D is incorrect. Cromolyn prevents the release of vasoactive mediators from mast cell and is primarily used for exercise-induced asthma, it is not indicated as an alternative agent in patients with moderate persistent asthma. E is incorrect. Ipratropium is a short-acting anticholinergic, which is often used in COPD or in asthma exacerbations. It is not indicated for maintenance treatment of moderate persistent asthma.

NEW QUESTION # 134
After talking to the patient you find out LT has been incompliant with her three times a day Valproic acid, level came back at 35 mmol/L.
What is the most appropriate course of action?

A. Valproic acid level is within normal limit, no adjustment is needed.
B. Albumin needs to be obtained to calculate corrected Valproic acid level
C. Notify the physician to decrease the dose of Valproic acid.
D. Notify the physician to increse the dose of Valproic acid.

Answer: A

Explanation:
Explanation
The delayed-release action of divalproex allows for less frequent dosing than valproic acid in some patients.
Divalproex sodium contains sodium valproate and valproic acid in a 1:1 molar stable co-ordination compound.
Valproic acid, sodium valproate, and divalproex share the same pharmacology; however, there are pharmacokinetic differences among products.

NEW QUESTION # 135
What is the Osmolarity of NS with KCL 40 meq/L? (MW of KCl: 74.55 g/mol) (MW of NaCl: 58.44 g/mol)

A. 800 mOsm/L
B. 388 mOsm/L
C. 830 mOsm/L
D. 308 mOm/L
E. 1108 mOsm/L

Answer: B

Explanation:
Explanation
KCl: Osmoles = number of particles in solution Convert 40meq to weight in g: 40meq * 1equiv/1000 mEq *
74.5g/1 equiv = 2.98g of KCL. Calculate mOsm/L: 2.98g/L * 1mol/74.5g * 2Osm/1 mol * 1000mOsm/1 Osm
= 80mOsm/L. NaCl: 0.9g/100ml * 1mol/58.5 g * 2 Osm/1mol * 1000 mOsm/ 1Osm * 1000ml/1L = 308 mOsm/L 80 mOsm/L + 308 mOsm/L = 388 mOsm/L

NEW QUESTION # 136
......

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Free PDF Quiz 2025 NAPLEX: North American Pharmacist Licensure Examination Useful Exam Fee

NABP North American Pharmacist Licensure Examination Sample Questions (Q131-Q136):

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